Abdo Flashcards
what are you looking for in hands, in abdo exam
clubbing leukonykia koilonykia palmar erythema Dupuyten contractures
causes of clubbing
GI:
- IBD
- Coeliac
- Cirrhosis
- Malignancy
Respiratory:
- malignancy
- cystic fibrosis
- bronchiectasis
- empyema (pus in chest)
How does clubbing present
inreased curvature of the nail, causing loss of Shamross window
what does palmar erythema indicate
CLD
what do dypuytrens indicate
cirrhosis
what does asterixis indicatew
Hepatic encepalopathy (due to toxin ammonia buildum) or CO2 retention
splenomegaly causes
Infection - TB, malaria, leishmaniasis
Inflammation: Portal HTN, Infiltrative - sarcoid, gaucher
Haem - myelofibrosis, chronic myeloma
causes of enlarged kidney
PKD
simple cyst
renal tumour
infiltrative (sarcoid, TB)
hepatomegaly causes
HEART: RHF
HEPATIC: Infection, inflammation and malignaancy
INFECTION:
- Hep B,C
- EBV, CMV
Inflammation:
- ALD, AI, NASH
- Amyloidosis
- Sarcoidosis
- Haemochomatosis
Malignancy:
- primary liver cancer
- metastatic liver
- lymphoma, leukaemia
how do you differentiate between kidney and spleen
spleen moves down with inspiration
cannot get above the spleen
spleen has a splenic notch
spleen is dull to percussion (kidneys are resonant)
KIDNEYS ARE BALLOTABLE
signs of CO2 retention
Asterixis (flapping tremor - due to brain irritation) Bounding pulse Vasodilation papilledema mental changes drowsiness
whatc causes leukonychia + presentation
hypoalbuminaemia (due to white spots on nails)
what causes koilonychia
iron deficiency anaemia (spoon nails)
what are you looking foor in the arms
tattoos / needle marks
petechiae / bruising
fistulae from renal haemodyalisis
what are you looking for in the eyes
conjunctival pallor (eyelid down)
scleral icterus (eyelid up)
kaiser fleisher rings
xanthalasma (PBC)
what are you looking for in the mouth
angular stomatitis (inflammation) aphtous ulcers in mouth atrophic glossitis (IDA) macroglossia (B12/folate deficiency)
what do you inspect for on abdomen when lying the bed flat
scars distension (mass/ascites/splenomeg) caput medusa Cullens/grey turners stomas
what are spider naevi, what can cause them
blanching telangectasing arteriole
- cirrhosis
- high levels of oestrogen
what is cullens sign and what can cause it
CULLEN’s = PERIUMBLICAL (acute pancreatitis, abdominal trauma, aortic rupture, ectopic pregnancy rupture)
what is grey turners and what can cause it
bleeding from the flanks (RETROPERITONEAL)
acute pancreatitis
causes of hepatosplenomegaly
chronic liver disease with portal hypertension
hematological disease, e.g. myeloproliferative disease, lymphoma, leukemia, pernicious anemia, sickle cell disease
infection, e.g. viral hepatitis, EBV, CMV
infiltration, e.g. amyloidosis, sarcoidosis
Connective tissue disorders e.g. SLE
acromegaly
thyrotoxicosis
